Archived: Mears Homecare Limited - Mary Seacole House

Updated 21 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 22, 24 and 26 May 2017. The first day of the inspection was unannounced and we informed the provider of our intention to return to the service on the second day. We visited the provider’s administrative offices in Chiswick on the third day of the inspection in order to look at staff recruitment records. One inspector and one assistant inspector visited on the first day and one inspector visited on the second and third days.

Prior to the inspection we reviewed the information we had about the service, which included the previous inspection report and statutory notifications the provider had sent to the Care Quality Commission. A notification is information about significant events which the provider is required by law to send to us. We contacted the local safeguarding team and also spoke with a representative of the local authority’s commissioning and contracts monitoring team, to find out their views about the quality of care and support provided to people who use the service.

During the inspection we read care and support plans for four people, with the accompanying risk assessments and risk management plans. We looked at a variety of policies and procedures for example safeguarding, managing medicines and information about how to make a complaint. We checked five staff recruitment files and looked at records for people’s financial expenditures, the administration of medicines, and accidents and incidents.

During the inspection we spoke with seven people who used the service and one relative, four care staff, the activities organiser who also provided personal care for an agreed limited number of hours each day, a member of the housekeeping team, a shift leader, the interim scheme manager and the interim manager. Following the inspection visits, we telephoned relatives and/or close friends of people who use the service and spoke with four people.

Updated 21 July 2017

This inspection was carried out on 22, 24 and 26 May 2017. We arrived unannounced on the first day and informed the provider of our intention to return to the service on the second day. The third day of this inspection was announced and comprised a visit to the provider’s administrative offices in a neighbouring borough. Mears Homecare Limited – Mary Seacole House provides personal care and support services to people living in their own homes in a purpose built building with 30 self-contained flats. The premises are managed and maintained by a housing association which is independent of Mears Homecare Limited. At the time of the inspection 24 people used the service and there were six vacancies. Each person is provided with 17 hours of personal care and housing related support every week, and can access a daily lunch and activities programme in the cafeteria and adjoining communal lounge area on the ground floor. The management and administration offices are located on the ground floor and all floors are accessible via a passenger lift.

A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of this inspection the service did not have a registered manager in post. The provider had arranged for the registered manager of another service to temporarily manage the service. The provider had also seconded an experienced extra care scheme manager to deputise for the acting manager when required and provide supervision and support for the staff team.

We found issues of concern in relation to the management of people’s prescribed medicines. The provider did not demonstrate that its own monitoring and auditing of the storage, administration and disposal of medicines was conducted in a thorough manner to protect people from the risks associated with unsafe medicine practices.

People informed us they felt safe living at the service. Staff understood how to safeguard people from abuse and report any concerns about people’s safety and welfare.

Risk assessments had been recently revised and updated to ensure that risks to people’ safety and wellbeing were identified and measures had been implemented to mitigate these risks.

People stated that there were enough staff deployed to meet their needs. Staff recruitment was properly conducted to make sure that staff were suitable to work with people who use the service.

The frequency of one to one formal supervision meetings to support staff with their duties had been disrupted, although the supervision programme had been commenced again by the interim management team. Staff had undertaken an assessment to ascertain their training and development needs and the provider’s forthcoming training programme had been arranged to take account of the staff team’s identified training requirements.

People told us they received the support they needed to meet their nutritional and health care needs; however, we received comments from relatives in relation to occasions when people had not been supported to attend health care appointments.

Staff confirmed they had received training and guidance about the importance of seeking people’s consent and promoting people’s entitlement to make decisions. The management team were aware of the actions to take if a person did not appear to have capacity to make decisions about their health and social care needs, for example the interim manager liaised with health care professionals at the local memory clinic if staff observed changes in people's cognitive abilities that could impact on their ability to make decisions.

Improvements had been achieved in regards to how people’s care and support plans reflected their individual needs, wishes and circumstances. People had been consulted by the provider at their annual review meeting and new documentation recorded relevant information about people’s social history, interests and family/friends support networks.

Although people were supported to participate in social activities which included chair based exercises and art sessions, there was no active approach by the provider to develop people’s access to a wider range of meaningful and fulfilling activities.

People were provided with information about how to make a complaint. Records indicated that the provider had not received any complaints since the previous inspection.

The provider’s record keeping system to demonstrate how people were supported by staff with their shopping and other expenditures was not accurately maintained. We found discrepancies and noted that filing was at times disorganised.

People’s views about the quality of their care and support had been sought and the provider had received some positive comments.

Our findings during this inspection demonstrated that the provider needed more rigorous monitoring systems to identify and address areas for improvement.

We have identified two beaches of regulation. These are in relation to the safe management of people’s medicines and the accurate record keeping for people’s finances. One recommendation has been made in regards to the need to provide people with a Service User Guide that addresses their circumstances as opposed to a general document not designed for people living in extra care schemes.

You can see what actions we have asked the provider to take at the end of the full version of this report.